Organization
SUPAKIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUPAKIT PEANCHITLERTKAJORN DDS, MDS (OWNER)
(214) 456-8825
Entity
Organization
Contact information
Practice address
6300 HARRY HINES BLVD, SUITE 600, DALLAS, TX 75235-5259
(214) 456-8825
(214) 456-8256
Mailing address
PO BOX 35408, DALLAS, TX 75235-0408
(214) 456-8825
(214) 456-8256
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21159
TX
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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